AMENDED IN SENATE OCTOBER 20, 2004

AMENDED IN ASSEMBLY OCTOBER 19, 2004

SENIOR ASSEMBLY PROPOSAL NO. 20

INTRODUCED BY SENIOR ASSEMBLY MEMBER LUCERO

LEGISLATIVE COUNSEL'S DIGEST

AP 20: MEDI-CAL ADMINISTRATIVE COSTS.

UNDER EXISTING LAW, THE STATE DEPARTMENT OF HEALTH SERVICES IS CHARGED WITH SPECIFIED DUTIES AND POWERS RELATING TO PUBLIC HEALTH, INCLUDING ADMINISTERING THE STATE MEDI-CAL PROGRAM.

THIS MEASURE WOULD MEMORIALIZE THE LEGISLATURE AND THE GOVERNOR TO ENACT LEGISLATION THAT WOULD ESTABLISH A QUALITY OUTSIDE INVESTIGATIVE TEAM TO REVIEW THE ADMINISTRATIVE COSTS OF THE MEDI-CAL PROGRAM AND, IF NECESSARY, TO PROPOSE MEASURES THAT WOULD LOWER THOSE COSTS SO THAT THEY ARE COMPARABLE TO THE ADMINISTRATIVE COSTS OF MEDICARE OR OTHER FEDERAL MEDICAL PROGRAMS.

VOTE: MAJORITY.

AP 20: RELATING TO MEDI-CAL ADMINISTRATIVE COSTS

WHEREAS, SENIOR CITIZENS, PERSONS WITH DISABILITIES, AND NEEDY FAMILIES HAVE THE LEAST AMOUNT OF MONEY AVAILABLE TO PURCHASE MEDICAL CARE BECAUSE OF THEIR LIMITED INCOME; AND

WHEREAS, MEDI-CAL IS A CALIFORNIA PROGRAM INSTITUTED TO ENSURE THAT CALIFORNIA'S CITIZENS ARE ABLE TO OBTAIN MEDICAL CARE; AND

WHEREAS, SENIORS CITIZENS, BECAUSE OF AGING FACTORS, ON AVERAGE, HAVE A GREATER NEED FOR MEDICAL ATTENTION; AND

WHEREAS, MEDI-CAL FUNDS AVAILABLE TO PAY FOR PATIENT TREATMENT ARE SO LIMITED THAT MANY PHYSICIANS ARE UNABLE TO TREAT PATIENTS WHO ARE ONLY COVERED BY MEDI-CAL; AND

WHEREAS, THE SCHEDULE FOR MEDI-CAL PROVIDER REIMBURSEMENT DOES NOT ALLOW FOR REIMBURSEMENT OF THE FULL COST OF PROVIDING CARE TO MEDI-CAL RECIPIENTS; AND

WHEREAS, PROVIDERS THAT CONTINUE TO TREAT PATIENTS THAT ARE ONLY COVERED BY MEDI-CAL ARE, THEREFOR, FORCED TO ABSORB SOME OF THE COSTS FOR MEDICAL SERVICES; AND

WHEREAS, IT IS ESTIMATED THAT THE ADMINISTRATIVE COSTS OF THE MEDI-CAL PROGRAM MAY BE AS HIGH AS 70 PERCENT OF THE MONEYS EXPENDED ON THAT PROGRAM; AND

WHEREAS, IT IS ESTIMATED THAT THE ADMINISTRATIVE COSTS OF FEDERAL MEDICARE PROGRAMS ARE ONLY 5 TO 10 PERCENT OF THE MONEYS EXPENDED FOR THOSE PROGRAMS; NOW, THEREFORE, BE IT

RESOLVED, BY THE SENIOR ASSEMBLY AND THE SENIOR SENATE, JOINTLY, THAT THE SENIOR LEGISLATURE OF THE STATE OF CALIFORNIA AT ITS 2004 REGULAR SESSION, A MAJORITY OF THE MEMBERS VOTING THEREFOR, HEREBY PROPOSES THAT A QUALITY OUTSIDE INVESTIGATIVE TEAM BE ESTABLISHED BY THE STATE TO REVIEW THE ADMINISTRATIVE COSTS OF THE MEDI-CAL PROGRAM AND, IF NECESSARY, TO PROPOSE MEASURES THAT WOULD LOWER THOSE COSTS SO THAT THEY ARE COMPARABLE TO THE ADMINISTRATIVE COSTS OF FEDERAL MEDICAL PROGRAMS AND TO PROVIDE THAT ANY REDUCTION IN THE ADMINISTRATIVE COSTS OF THE MEDI-CAL PROGRAM BE APPLIED TO PATIENT CARE; AND BE IT FURTHER

RESOLVED, THAT THE SENIOR LEGISLATURE OF THE STATE OF CALIFORNIA RESPECTFULLY MEMORIALIZES THE LEGISLATURE AND THE GOVERNOR OF THE STATE OF CALIFORNIA TO ENACT APPROPRIATE LEGISLATION WHICH WOULD ADDRESS THE CONCERNS SET FORTH IN THIS MEASURE; AND BE IT FURTHER

RESOLVED, THAT A COPY OF THIS MEASURE BE TRANSMITTED TO THE SPEAKER OF THE ASSEMBLY, THE PRESIDENT PRO TEMPORE OF THE SENATE, AND THE GOVERNOR OF THE STATE OF CALIFORNIA.

RN0415708

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